Mpox (monkeypox) risk and mortality associated with HIV infection

A national case–control study in Nigeria

Bibliographic Data

ID21879717
AuthorsAdesola Yinka-Ogunleye (0000-0003-0900-4772, Nigeria Centre for Disease Control, corresponding author), Mahmood Dalhat (0000-0003-0229-9838, African Field Epidemiology Network), Afolabi Akinpelu (0000-0002-1837-6255, Laboratoire National de Référence), Olusola Aruna (0000-0002-7879-634X, UK Health Security Agency), Fatima Garba (African Field Epidemiology Network), Adama Ahmad (Laboratoire National de Référence), Adesola Adeleye (Laboratoire National de Référence), Iliya Botson (Laboratoire National de Référence), Bamidele Oluwafemi (Nigeria Centre for Disease Control), Oluwafemi Bamidele (0000-0003-2730-4031, Laboratoire National de Référence), Oladipo Ogunbode (0000-0001-8337-796X, Nigeria Centre for Disease Control), Lateefat Amao (0000-0002-8031-5883, Nigeria Centre for Disease Control), Udeme Ekripo (University of Uyo Teaching Hospital), Gambo Aliyu (0000-0002-9661-3463, Prevention Institute), Gambo Gumel Aliyu (Epidemiology and Prevention, Institute of Human Virology, Baltimore, Maryland, USA), Ifedayo Adetifa (0000-0003-2556-9407, London School of Hygiene & Tropical Medicine), Chikwe Ihekweazu (0000-0003-0659-0833, Nigeria Centre for Disease Control), Ibrahim Abubakar (0000-0002-0370-1430, University College London)
Year2023
Volume8
Issue11
Pagese013126
Publication date2023-11-01
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2023-013126
PMID38035733
OpenAlexW4389245012
LanguageEN
Citations received3
References cited26

INTRODUCTION: Recent outbreaks of mpox are characterised by changes in the natural history of the disease, the demographic and clinical characteristics of the cases, and widening geographical distribution. We investigated the role of HIV and other sexually transmitted infections (STIs) coinfection among cases in the re-emergence of mpox to inform national and global response. METHODS: We conducted a national descriptive and case-control study on cases in the 2017-2019 Nigerian mpox outbreak. Mpox cases were age, sex and geographical area matched each with two randomly selected controls from a representative national HIV/AIDS survey. Logistic regression was used to investigate the association between HIV infection and the risk of mpox acquisition and death. RESULTS: Among 204 suspected mpox cases, 86 were confirmed (median age 31 years (IQR 27-38 years), mostly males (61 cases, 70.9%). Three-fifths of mpox cases had serological evidence of one or more STIs with 27.9% (24/86) coinfected with HIV. The case fatality rate was 9.4% (8/86) and 20.8% (5/24) overall and in HIV positive cases respectively. Mpox cases were more likely to have HIV coinfection compared with an age, gender and geography-matched control group drawn from the general population (OR 45 (95% CI 6.1 to 333.5, p=0.002) and when compared with non mpox rash cases (7.29 (95% CI 2.6 to 20.5, p<0.0001)). HIV coinfection and young age were associated with mortality among mpox cases (aOR 13.66 (95% CI 1.88 to 98.95, p=0.010) and aOR 0.90 (0.82-0.97, p=0.008), respectively). CONCLUSION: HIV infection was associated with a higher risk of contracting and dying from mpox. Children are also at high risk of death. STIs in mpox cases may be suggestive of high-risk sexual behaviours among these individuals

Case fatality rate · Coinfection · Environmental health · Logistic regression · Mortality rate · Outbreak · Population · Demography · Immune responses and vaccinations · Medicine · Poxvirus research and outbreaks · Virology and Viral Diseases · Epidemiology · Immunology · Internal Medicine · Virology

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